FOR PEDIATRIC SURGERY

1. Prof. Dr. Hussein Abd EL
Dayem

2. http://www.slideshare.net/husseindayem/brain-plasticity-12531271
Facebook.com/ Pediatric Neurology Unit –
Alshatby Hopsital

5.  CNS begins from 2
weeks gestation
 10% of the cells are
neurons ( 100 billion)
 Neurons makes 1,000 to
20,000 connections
 There is no inferiority or
superiority between
male and female brains
 At birth, brain weighs
350 g, at one year 1000 g
 Uses 20% of the body
energy
 Consume 20 % of the
body oxygen
 All parts of brain are
involved in learning,
some more than other

6. NOT ONE NERVE
CELLS
• Kidney
• Heart
• Liver
• Lung
• Pancreas
• Intestine
• Cornea
• Skin
• Bone
• Bone Marrow
ORGAN TRANSPLANTS

7.  •The number of neurons that a child is born with is
largely fixed around four months before birth
 •The most important mechanisms involved in the
massive brain spurt that occurs in the early years
of life are:
–Myelination
–Production of glial cells
–Synaptogenesis: creation of synapses

8. Answer: Brain reacts and adapts in response to
challenge.
Brain Plasticity
the capability of the brain to alter its functional
organization as a result of experience or
sensory stimulation.
The brain’s ability to adapt/modify itself,
especially after injury/ need/ experience.

9.  Plasticity in physics : propensity of a material
to undergo permanent deformation under load
 Entire brain structure can change to better cope
with the environment. Specifically when an
area of the brain is damaged and non-
functional another area may take over some of
the function
The brain’s ability to adapt/modify itself,
especially after injury.

10.  1- At the beginning of life: when the immature
brain organizes itself (developmental plasticity).
 2- Through adulthood: whenever something
new is learned and memorized (acquired
plasticity of learning and memory)
 3- In case of brain injury: to compensate for lost
functions (injury – induced plasticity)

11. The brain can change in many ways such as:
 A change in the internal structure of the
neurons, particularly at the area of synapses.
 An increase in the number of synapses between
neurons.
Brain plasticity and self-healing has limits,
but what it can do is still impressive.

12.  Brain cells do not necessarily re-grow after trauma…
 but the brain as a whole can re-organize itself.
 This plasticity is most potent when we are young.

13.  Early childhood experiences physically
determine how the brain is "wired."
 Early sensory experiences create new synapses.
 Repetition of experiences strengthen them.
 The number of connections can go up or down
by 25 % or more, depending on the enrichment
of the environment.
 Those synapses that aren't used are pruned.

15.  Neurons develop rapidly before birth.
 At birth, infants have all, or most, of the brain cells
they will ever have.
 Connections or "wiring" between these cells is
incomplete - connections have to be built.
 Between birth and 8 months synapses form rapidly.
 One neuron can connect with 15,000 other neurons.
 In the first 3 months of life, the synapses multiply
more than 20 times.
 At 3 months, the baby has more than 1,000 trillion
synapses.
Over the first few years of life, the
brain grows rapidly. As each neuron
matures, it sends out multiple
branches (axons, which send
information out, and dendrites,
which take in information), increasing
the number of synaptic contacts and
laying the specific connections from
neuron to neuron. At birth, each
neuron in the cerebral cortex has
approximately 2,500 synapses. By the
time an infant is two or three years
old, the number of synapses is
approximately 15,000 synapses per
neuron (Gopnick, et al., 1999(.

16.  After the first birthday, pruning occurs more
quickly.
 A 3-year-old child has twice as many
connections as an adult.
 By 10 years, a child has nearly 500 trillion
synapses, which is the same as the average
adult.

17. it is responsible for deleting old connections as
frequently as it enables the creation of new
ones.
synaptic
pruning
Connections that are not used are removed
by "pruning"

20.  Touch, sound, sight, taste, smell, all build
connections .
 Touch also is key to brain development
 Research on infant massage suggests that in
preemies, massage causes faster growth and
development.

21.  At 3 months the brain has the potential to
distinguish several hundred spoken sounds.
 During early childhood the brain retains
plasticity for this information
 After age ten, this plasticity is lost
 Older children & adults can still learn language,
but more effort is required.

22.  Infants in environmentally deprived facilities
have brains smaller than those of children who
grow up in sensually rich environments
 In some cases the brains of children from
deprived environments resemble the brains of
Alzheimer's patients.

23. Children have an enhanced capacity for brain
plasticity compared to adults :
 1- their superior ability to learn a second
language or
 2-their capacity to recover from brain injuries
as in stroke or radical surgery such as
hemispherectomy for epilepsy

24.  Challenges to the brain create change
throughout our lifetime.
 Intention can change our brain.
 Intention to move the eyes has an effect
even if you cannot move the eyes
 Exercise and Fun Increase Brain Function
 Physical Touch Brings Healing

25.  neuroplasticity is the lifelong ability of our
brains to reorganize neural pathways based on
new experiences as learning
 Critical periods: limited time during which the
nervous system displays heightened sensitivity
to environmental stimuli and develops in
particular directions as a result of these
stimuli.

26.  The plasticity of the brain is maximal during
the first 2 years of life; the critical period.
 In this period crucial experiences will have its
peak effect on development or learning.
 After the critical period, the brain may never
again show the same ability to make big changes
in neuronal connectivity.

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29. BENEFITS

30.  EIP is a program that aims at saving kids who
are at risk of developing a handicapping
condition or other special need that may
affect their development.

31.  Children are eligible for the Early
Intervention Program if they are under 5 years
old AND have a disability OR developmental
delay.

32.  Child development research has established
that the rate of human learning and
development is most rapid in the preschool
years.
 Timing of intervention becomes particularly
important when a child runs the risk of
missing an opportunity to learn during a state
of maximum readiness

33.  The Early Intervention Program offers a
variety of therapeutic and support services to
eligible infants and toddlers with disabilities
and their families

34.  Families of handicapped children are found
to experience increased instances of divorce
and suicide, and the handicapped child is
more likely to be abused than is a non-
handicapped child.
 Early intervention can result in parents
having improved attitudes about themselves
and their child, improved information and
skills for teaching their child, and more
release time for leisure and employment.

35. Only qualified professionals – individuals in
their discipline– can deliver early
intervention services. All early intervention
services can be given using any of the
following service models:

36.  Home- and community-based visits.
 Facility or center-based visits.
 Parent-child groups.
 Family support groups.
 Group developmental intervention.

37.  (a) the age of the child at the time of
intervention;
 (b) parent involvement ; and
 (c) the intensity and/or the amount of
structure of the program model

38. After nearly 50 years of research, there is
evidence--both quantitative (data-based) and
qualitative (reports of parents and teachers)--
that early intervention increases the
developmental and educational gains for the
child, improves the functioning of the family,
and reaps long-term benefits for society.

39.  recovery is remarkable when the brain is
damaged early in life

41. DS GDD

42. CP SPASTIC DIPLEGIA

43.  Early CP hemiplegia
 IN cortical blindness
 IN cortical deafness

45. FINE MOTOR

47. GROUP THERAPY

48. GDD GDD

49. MR MR

52. New brain cells (neurons) can be grown our entire
life in the hippocampus

53.  BY making new learning a priority activity in
your everyday life
 BY regularly exercising your brain :
exposing your brain to the kinds of
information, images, concepts, relationships
that you would like the majority of your
thoughts to be made up of, these are activities
that can truly change your brain!

54.  If you can devote some time to new learning and
experiences as well as exercising your brain and
acquiring new skills…..
>>>>>>>>>>>>> DO IT
 Don't let age serve as an excuse, either: as the
research has shown, your brain's plasticity is largely
intact and waiting, even into old age. So sorry, no
saying "I'm too old to learn Japanese" or "I'm no good
at even simple math equations anymore".

56. THANK
YOU

57.  FACT 1: Neuroplasticity includes several different
processes that take place throughout a lifetime.
 FACT 2: Neuroplasticity has a clear age-dependent
determinant. Although plasticity occurs over an
individual’s lifetime, different types of
plasticity dominate during certain periods of
one’s life and are less prevalent during other
periods

58.  FACT 3: Neuroplasticity occurs in the brain under
two primary conditions:
1. During normal brain development when the
immature brain first begins to process sensory
information through adulthood (developmental
plasticity and plasticity of learning and memory).
2. As an adaptive mechanism to compensate for
lost function and/or to maximize remaining
functions in the event of brain injury.

60.  adaptive plasticity that enhances skill
development or recovery from brain injury
 impaired plasticity associated with cognitive
impairment; as in fragileX syndrome
 excessive plasticity leading to maladaptive brain
circuits as in focal dystonia
 plasticity that becomes the brain's `Achilles' Heel'
because makes it vulnerable to injury. As in SE

62.  • Cortical maps
 • Synaptic morphology
 • Dendritic morphology
 • Synaptic strength
 • Receptor binding
 • Neurogenesis
 • others

63.  Neurons that fire together wire together!
 When cells are active together synapses are
strengthened and preserved.
 The neurons & synapses that are activated
repeatedly are preserved while those who aren’t
are pruned.

64.  At about age 10, the brain begins to dramatically
prune extra connections and make order of the
tangled circuitry of the brain.
 Pruning occurs for about 12 years but the brain
maintains flexibility for future learning
 New synapses grow throughout life
 Adults continue to learn, but they do not master
new skills so quickly
 Learning language is an example of this principle.

67. family education and counseling, home visits,
and parent support groups
special instruction
speech pathology and audiology

68. occupational therapy
physical therapy
psychological services

69. Nursing Services
Nutrition Services
Social work studies
And other services ….

70.  Early intervention services have a significant
impact on the parents and siblings of an
exceptional infant or young child.
 The family of a young exceptional child often
feels disappointment, social isolation, added
stress, frustration, and helplessness. The
compounded stress of the presence of an
exceptional child may affect the family's well-
being and interfere with the child's
development.

71.  Auditory discrimination ability better in
blind than sighted adults
 Better sound localization ability?
?? Altered center, ? Altered peripheral?

72.  BRAIN INJURY
 Brain plasticity helps in recovery from brain
injuries such as that caused from stroke or head
trauma.
 Recent studies showed that brain cells
surrounding the damaged area undergo
changes in their function & shape that allow
them to take on the function of the damaged
cells.

73.  Brain plasticity helps in recovery from
brain injuries such as that caused from
stroke or head trauma
 Recent studies showed that brain cells
surrounding the damaged area undergo
changes in their function & shape that
allow them to take on the function of the
damaged cells.